WASHINGTON — In a stinging setback for one of their top priorities, Senate Republicans scrapped a planned vote on a last-ditch Obamacare repeal bill Tuesday, conceding that the party did not have the votes to pass it.

Majority Leader Mitch McConnell, R-Ky., had planned to bring the bill, crafted by Sens. Lindsey Graham and Bill Cassidy, to the floor for a vote this week as Republicans raced to beat a Sept. 30 deadline. Senate GOP leaders were using special budget rules that bar a Democratic filibuster and require only 50 votes to pass, but that authority expires Saturday.

With GOP Sens. Susan Collins of Maine, John McCain of Arizona, and Rand Paul of Kentucky all opposed, the bill did not have enough Republican support to pass. Democrats were united against the Graham-Cassidy bill, and Republicans hold a narrow 52-48 majority in the Senate, so McConnell could lose only two GOP votes.

"Where we go from here is tax reform," McConnell said on Tuesday after a Senate Republican luncheon where they discussed the bill's demise. But, McConnell added, "we haven't given up on changing the American health care system."

After Tuesday’s collapse of the Graham-Cassidy bill, Sen. Lamar Alexander, chairman of the Senate health committee, said he would try to restart bipartisan talks on a “limited” plan to shore up the individual market and make other short-term fixes to the ACA. The Tennessee Republican said he supported the GOP-only bill but suggested Congress could not walk away from urgent problems with the current health care system.

“Congress has an opportunity to slow down premium increases in 2018, begin to lower them in 2019, and do our best to make sure there are no counties where people have zero options to buy health insurance,” Alexander said in a statement Tuesday.

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Speaker of the House Paul Ryan said he and other GOP Congress members are "frustrated" with the Senate's inability to make moves on their health care bill. (Sept. 26)
AP

“We need to pick up right back where we left off, and we need to do it right now,” said Sen. Patty Murray of Washington, the top Democrat on the health committee. Alexander and Murray had been working together earlier this month, but their efforts were derailed by the Republicans' push to replace the ACA with the GOP-only bill.

Graham, standing beside McConnell to brief reporters Tuesday afternoon, said Senate Republicans would eventually return to the Graham-Cassidy bill after they finished tax reform, and he predicted it would eventually pass.

But Republicans remain deeply divided over how far to go in repealing Obamacare, with moderates urging the preservation of key Affordable Care Act protections for the most vulnerable Americans and conservatives pushing for completely killing the law.

The three senators who had said they would vote "no" on the Graham-Cassidy proposal gave three different reasons for their opposition. Collins said the bill was flawed on multiple counts, saying, for example, that it would not protect Maine’s most vulnerable residents and would undermine protections for those with pre-existing conditions. McCain objected to GOP-only process for drafting the bill without hearings and with limited debate. Paul said the legislation did not go far enough in repealing Obamacare.

"It's complicated, it's difficult politics," Graham conceded.

The politics will only become more treacherous, as Republican voters absorb the GOP’s failure to pass an Obamacare replacement bill.

Tuesday's GOP flop is a huge blow for President Trump, who had personally lobbied lawmakers to support the Graham-Cassidy bill and invested significant political capital in a repeal. But it's an even more blistering defeat for McConnell and his Senate GOP troops, who have spent seven years promising their conservative constituents they would repeal and replace the ACA.

"Once again, Senate Republican ‘leadership’ has demonstrated that its promises are meaningless," Tea Party Patriots co-founder Jenny Beth Martin said in a statement after McConnell's announcement. "With total control of the executive and legislative branches, the Republican Senate majority cannot even pass a bill that only repeals a portion of Obamacare. The American people have a simple message for promise-breaking politicians: If you can’t keep your word, we will find someone else who will.”

Republicans are even divided over the narrower push for a bipartisan, short-term fix led by Alexander and Murray. Collins said that is the best course forward, and that compromise would help "the insurance markets, create more choices for consumers, and lower premiums."

But some Republicans suggested that Obamacare was beyond repair and should be allowed to collapse.

“Personally I think it’s time for the American people to see what the Democrats have done to them on health care. They’re gonna find they can’t pay for it, they’re gonna find it doesn’t work, they’re gonna find that some of these so called liberal approaches don’t work," said Sen. Orrin Hatch, R-Utah, chairman of the Senate Finance Committee. "Now, that makes it tough on everybody but maybe that’s what it takes to wise people up.”

Michael A. Needham, CEO of the conservative Heritage Foundation, said that talks for a bipartisan approach were "unacceptable, and Heritage Action will oppose efforts to prop up the failing law."

Before McConnell's announcement, Trump said the fight over health care was not over. He also suggested he would continue to attack McCain and other Republicans who opposed Graham-Cassidy.

"We are disappointed in certain so-called Republicans" who abandoned the bill, Trump said. "It's going along and at some point, there will be a repeal and replace."

The Graham-Cassidy plan would have kept most of the taxes that fund the ACA but sent that revenue to the states in the form of block grants to craft their own insurance systems. The legislation called for ending the Affordable Care Act's Medicaid expansion and transforming federal funding stream for Medicaid from a set federal percentage of the program's overall costs to a capped per-capita allotment.

The measure would also have allowed states to apply for waivers from key Obamacare provisions, such as protections for those with pre-existing conditions and requirements that insurers offer basic coverage that includes maternity care, hospitalization, and substance abuse treatment.

Although Collins, McCain and Paul were the only publicly declared "no" votes, they were not the only ones expressing concerns. Conservative Texas Sen. Ted Cruz, for example, said over the weekend that he was against the current version of the bill but was still hoping to get to a "yes."

Sen. Lisa Murkowski, a moderate from Alaska, did not disclose her position on the Graham-Cassidy proposal, but she had previously raised many of the same concerns as Collins. And she joined McCain and Collins in voting against a previous Senate GOP bill to repeal Obamacare.

After GOP leadership announced there would be no vote, Murkowski issued a statement that said she appreciated Graham and Cassidy’s efforts but they were “up against a hard deadline and a lousy process.”

“In the House, we’re a little frustrated because the House has done its job,” Ryan said. But the House’s top Republican indicated he was ready to move on to tax reform, which he said “affects every single American.”